Circuit Court for Case No. City or County vs. Name Name Apt. # Street Address City State Zip Code Area Code Apt. # Street Address Telephone City State Plaintiff Zip Code Area Code Telephone Defendant AFFIDAVIT OF SERVICE (Certified Mail) (DOM REL56) I certify that I served the following documents (Check all that apply): Writ of summons Complaint/Petition/Motion: List name of complaint/petition/motion Domestic Case Information Report (DCIR Form) Financial Statement Show Cause Order and Petition: List type of petition Other: List all other documents served which were previously filed with this Court upon Name of person served on , , at Date Street Address City State Zip Code by certified mail, restricted delivery, return receipt requested. The original return receipt signed by is attached. Also attached is a copy of any summons ("process") Name of person served issued by the Court, the original of which I included in the certified mail service upon the person served. I certify that I am over eighteen (18) years of age and I am not the Plaintiff or the Defendant. I SOLEMNLY AFFIRM under penalties of perjury that the contents of the foregoing paper are true to the best of my knowledge, information, and belief. Date Name of person certifying service (signature) Name of person certifying service (printed or typed) City Street Address of person certifying service ( CC-DR 56 (Rev. 3/2008) ) Area Code State Zip Code Telephone Number of person certifying service American LegalNet, Inc. www.FormsWorkflow.com